Heat Illness, Quality of Life
Conditions
Keywords
heat illness, behaviour modification, personal cooling, Structural modification, heat adaptation, prevention, quality of life
Brief summary
This study aims to understand whether simple, low-cost interventions, such as improved home cooling, practical advice, and minor home modifications, can help protect people's health and improve quality of life during periods of extreme heat in densely populated, low-income neighborhoods of Karachi, Pakistan. Key Questions the Study Seeks to Answer: 1. Can these interventions reduce heat-related health problems such as dizziness, headaches, and heatstroke and improve the quality of life? 2. Can they lower indoor temperatures and improve sleep quality, comfort, and daily functioning? To answer these questions, researchers will compare communities where families receive heat-related support and information with similar communities that do not, to assess any differences in health and well-being. What Participants Can Expect: * Answer questions about their health, living conditions, and how they cope with heat * Have small temperature sensors placed inside their homes * Some participants may wear a lightweight wristband that tracks sleep and heart rate * In selected households, cooling improvements will be made, such as adding shade, applying reflective roof paint, or enhancing airflow Purpose: This study seeks to identify affordable and effective strategies to help families stay safe during extreme heat, and to use these insights to support other vulnerable communities facing similar challenges.
Interventions
BEHAVIORALCommunity education and awareness, and personal lifestyle and cooling behavior modification
This component of the ReHAB will be achieved through community mobilization, which will encompass awareness and motivational activities throughout the intervention duration. Community groups (CGs) will be formed in each of the 11 clusters. Both male and female CGs will be formed separately and will be responsible for community mobilization activities, surveillance for primary outcome. Each CG will comprise of 6-8 members and will be a diverse group of people with varying qualifications, including local government members, local elders/elites, religious leaders, and prominent male and female members of the community. they could also name their respective CGs to enhance association, identity, and affiliation. These CGs will facilitate culturally tailored workshops, dissemination of early warnings regarding heat waves, awareness sessions, and door-to-door outreach focused on heat-health fundamentals. CGs will also maintain simple logbooks to track any incidence of heat related illness.
Participatory local structural and environmental heat mitigation solutions will be delivered through community participatory approach where the community and project will share the cost of intervention to improve ownership. This contribution can be monetary or non-monetary, for example, provision of labor or supplies. The modifications include: 1. Paints (Solar Reflective Paints, Lime Paints) 2. Shading (Façade, Roof) 3. Energy Sufficiency (Solar Panels with complete accessories) 4. Community Shading (Plantation, Street Shading, Field Shading space) 5. Ventilation (Windows, Wind catchers)
Sponsors
Aga Khan University
London School of Hygiene and Tropical Medicine
University College, London
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Cluster Randomized Controlled Trial
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* All households within the selected clusters who provide consent.
Exclusion criteria
* Households planning to move away from the study site within the next 6 months * Individuals with severe mental or physical health conditions that preclude participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants with Heat-Related Illness | from baseline to 24 months | Heat-related illness is defined as any condition resulting from prolonged heat exposure, including heat stroke, heat exhaustion, heat syncope, heat cramps, or heat rash. Data will be collected through weekly household surveillance, and community group reports |
| Quality of Life Enhancement | 4 month, 7 month, 16 month, 19 month | Change in the WHOQOL-BREF overall score (mean of domain scores) during two consecutive peak summer and winter seasons |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| All-cause mortality (Number of Deaths from Any Cause) | from baseline to 24 months | All-cause mortality refers to the total number of deaths from any cause among trial participants during the study period, confirmed via household visits and healthcare facility records. |
| Number of Participants with At Least One Hospital Visit During Study Period | During summer months for 2 years | Defined as the number of participants who visited a secondary or tertiary healthcare facility for any reason during the study period, confirmed by self-report and facility-based records. |
| Number of Participants Hospitalized for at Least 24 Hours | During summer months for 2 years | Defined as the number of participants who were admitted to a hospital for at least 24 consecutive hours during the study period, verified through hospital admission records and participant reports. |
| Change in Self-Reported Thermal Comfort Score | from baseline to 24 months | Thermal comfort will be assessed using a modified version of the CHEQ-5 thermal comfort survey. Participants rate their satisfaction with indoor thermal conditions. The scale ranges from 1 (very uncomfortable) to 5 (very comfortable). Higher scores indicate better thermal comfort. Assessments will be conducted at baseline, and then monthly afterwards. |
| Change in Indoor Heat Index | From intervention delivery to 24 months | Measured as the difference in average indoor heat index before and after intervention using fixed indoor temperature loggers (iButton sensors or Temp-U data loggers). Data collected continuously throughout the study. |
Countries
Pakistan
Contacts
CONTACTJai K Das
PRINCIPAL_INVESTIGATORjai K Das
Institute for global health and development, Aga Khan University.
Outcome results
None listed